The third open-enrollment period for the Affordable Care Act ended with 239,034 people in Wisconsin enrolled in health plans sold on the federal marketplace, a 16% increase from the same point last year, the federal government said Thursday.

Those figures include 89,480 people in the Milwaukee area, a 72% increase from the 52,115 people at the end of the open-enrollment period last year.

"We pulled out all the stops in terms of leafleting and the grass-roots work," said Clare Reardon of the Milwaukee Enrollment Network, a coalition created to help people sign up for coverage.

The increase for Milwaukee and Wisconsin outpaced the average for the country.

Nationally, 12.7 million people enrolled in health plans sold on the federal or state marketplaces set up through the Affordable Care Act, also known as Obamacare, according to the U.S. Department of Health and Human Services. That's an 11% increase from the roughly 11.4 million people who bought or were re-enrolled in the plans at the end of the open-enrollment period last year.

More than 9.6 million people were in health plans sold through the federal marketplaces and 3.1 million were in plans sold on the state marketplaces.

"The ACA is helping millions of people and has become an important part of health care in America," HHS Secretary Sylvia M. Burwell, said in a teleconference.

Roughly 183,000 people in Wisconsin were covered by health plans sold on the marketplace as of June — a drop of 22,000 from the number at the end of the open-enrollment period a year ago.

Opposition to the law remains strong among most Republicans. Congress this week failed in yet another attempt to repeal key parts of the law. And all the Republican presidential candidates have vowed to repeal it.

The Affordable Care Act expands insurance coverage by giving states incentives to expand their Medicaid programs for the very poor and by subsidizing the cost of private health plans sold on the marketplaces for people who have low or middle-class incomes and who don't get health insurance through an employer.

More than 90% of the country now has health insurance — the highest percentage ever, Burwell said. And that percentage could increase in future years as more states expand their Medicaid programs and more people sign up for coverage.

The penalty for not having health insurance increases this year to $695 or 2.5% of taxable income, whichever is higher, for individuals.

"The fine really was a motivator this year," said Reardon, of the Milwaukee Enrollment Network.

That could help health insurers by prodding more people who are healthy to sign up for coverage.

Health insurers overall have lost money on the health plans sold on the marketplace in part because a disproportionate number of people in poor health enrolled in the first two years.

The Affordable Care Act requires health insurers to cover people who have pre-existing health conditions.

That changed the market for health plans sold to individuals and their families, said Andy Slavitt, the acting administrator for the federal Centers for Medicare and Medicaid Services.

"We certainly would expect there to be growing pains along the way," he said during the teleconference.

Caroline Gomez-Tom, navigator program manager for Covering Wisconsin, which had a federal grant to help people sign up for coverage, was encouraged by the gains in coverage.

"We thought it would be harder to reach people," she said. But she added, "This is our third year of doing this, and we've become a little bit more savvy."